Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Dermatol. Nov 2, 2015; 4(4): 135-144
Published online Nov 2, 2015. doi: 10.5314/wjd.v4.i4.135
Mycosis fungoides: A mimicker of benign dermatoses
Marion Wobser, Eva Geissinger, Andreas Rosenwald, Matthias Goebeler
Marion Wobser, Matthias Goebeler, Department of Dermatology, Venereology and Allergology, University Hospital Wuerzburg, 97080 Wuerzburg, Germany
Eva Geissinger, Andreas Rosenwald, Institute of Pathology, University of Wuerzburg, 97080 Wuerzburg, Germany
Author contributions: Wobser M, Geissinger E, Rosenwald A and Goebeler M contributed in conception and design of the review; all authors were involved in drafting and/or revising the article and finally approved the version to be published.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Marion Wobser, MD, Department of Dermatology, Venereology and Allergology, University Hospital Wuerzburg, Josef-Schneider-Str. 2, 97080 Wuerzburg, Germany.
Telephone: +49-931-20126001 Fax: +49-931-20126700
Received: June 23, 2014
Peer-review started: June 23, 2014
First decision: August 14, 2014
Revised: June 24, 2015
Accepted: July 16, 2015
Article in press: July 17, 2015
Published online: November 2, 2015

Mycosis fungoides, the most common primary cutaneous lymphoma, may present with a broad spectrum of clinical features. As both clinical and dermatopathological findings in mycosis fungoides occasionally closely imitate other dermatoses, correct diagnosis may be a challenge both for clinicians as well as dermatopathologists. As a consequence, diagnosis of cutaneous lymphoma may be initially missed and, therefore, prompt and adequate therapeutic measures delayed. Hence, the purpose of our article was to give an overview of hitherto published “mimickers” of mycosis fungoides with a review of its diverse clinical features to alert the clinicians about the wide spectrum of this dissimulating disease. By integrating our own encountered atypical cases of mycosis fungoides we provide a comprehensive illustrated histological and moleculargenetic workup thereof and thereby critically revise the different available diagnostic tools of daily routine. Finally, we derive a practical algorithm to obtain the correct diagnosis even in such ambiguous cases of mycosis fungoides.

Keywords: Mycosis fungoides, Cutaneous lymphoma, Mimicker, Imitator, Inflammatory dermatosis

Core tip: Mycosis fungoides, the most common cutaneous lymphoma, may imitate diverse diagnoses both on clinical and on histological grounds. Hence, the former “great masquerader” syphilis may be regarded as being outpaced. As diagnosis of such ambiguous, atypical cases of mycosis fungoides may be a challenge for the dermatologist and pathologist and consecutively adequate therapeutic measures may be delayed we herein give a comprehensive overview on previously published cases accomplished by our own data. We conclude that a multi-step diagnostic algorithm including meticulous clinicopathological correlation together with molecular genetic analysis should be applied in such protean cases to obtain the correct diagnosis.